Oligo/Amenorrhea Is an Independent Risk Factor Associated With Low Ovarian Response

Abstract

CapsuleOligo/amenorrhea is an independent risk factor of low ovarian response but not high ovarian response, particularly in women with low AMH levels.ObjectiveTo investigate the association of menstrual cycle length (MCL) with anti-Müllerian hormone (AMH) and ovarian response.MethodsThis was a retrospective cohort study. A total of 7471 women who underwent ovarian stimulation and oocyte retrieval were enrolled. The main outcome was the number of oocytes retrieved.Main ResultsA total of 5734 patients were eligible for analysis. In women without polycystic ovary syndrome (PCOS), serum AMH levels and antral follicle count were significantly lower in women with short cycles and higher in women with oligo/amenorrhea than those with a normal menstrual cycle. In women with PCOS, compared to women with a normal menstrual cycle, women with short cycles and women with oligo/amenorrhea showed higher antral follicle count and higher serum AMH levels. Compared with the 0-25th range group of AMH levels, 75-100th percentile groups showed a significantly increased rate of oligo/amenorrhea in women with and without PCOS [adjusted odds ratio (OR) =1.9 (1.04, 3.46), 2.4 (1.70, 3.35)]. In women without PCOS, the low ovarian response was more common in women with short cycles and less common in women with oligo/amenorrhea compared to women with normal cycles [OR=3.0 (2.38, 3.78), 0.7 (0.55, 0.96), respectively]. When adjusted for AMH levels, both short cycles and oligo/amenorrhea were associated with an increased risk of low response [adjusted OR=1.3 (1.02, 1.75), 1.3 (0.93, 1.86), respectively]. In women without PCOS and with low AMH levels, the low ovarian response was more common in women with short cycles as well as in women with oligo/amenorrhea [OR=1.5 (1.08, 1.98), 1.7 (1.08, 2.69), adjusted OR=1.2 (0.86, 1.74), 2.2 (1.31, 3.82), respectively].ConclusionAMH levels are significantly associated with increased risk of oligo/amenorrhea in women with and without PCOS. AMH is an indispensable confounder in the association between MCL and ovarian response in women without PCOS. Oligo/amenorrhea is an independent risk factor associated with a low ovarian response in women without PCOS, particularly those with low AMH levels.

Current understanding of the genomic abnormities in premature ovarian failure: chance for early diagnosis and management

“…Notably, in another study, the p.Ala307Thr variant has also been identified in 3 German patients with POF (143). In terms of this, menstrual dysfunction precedes the initiation of amenorrhea, such as oligomenorrhea, transient amenorrhea and short cycles, which might be a special signature for ovarian failure and are regarded as "prodromal POF" (160). In terms of this, future investigations are needed to explore the potential roles of other FSHR variants in the development of POF.…”

Rates of Menstrual History-Taking and Counseling With Anticancer Treatments Are Low: People Who Menstruate Deserve Gender-Specific Cancer Care

“…8 There is conflicting evidence regarding the link between biochemical markers of reduced ovarian reserve and patients' menstrual patterns 9 ; however, cancer survivors with irregular menses have been found to have decreased ovarian reserve and reproductive potential. 10,11 Gonadotoxic injury from cytotoxic therapy can manifest as the cessation of regular menses and development of menopausal symptoms, such as hot flushes, vaginal dryness, and dyspareunia, and also increases osteoporosis risk, all of which can negatively impact on patients' quality of life. 4,12 More than one-half of survivors of Hodgkin lymphoma and breast cancer report chemotherapy-induced amenorrhea, although the definition of this varies substantially across cancer literature.…”